Follow-up tuberculosis prevalence survey of Transkei

Fourie, P. Bernard; Gatner, E. M. S.; Glatthaar, E; Kleeberg, H. H.

doi:10.1016/0041-3879(80)90013-6

Cited by 17 publications

(8 citation statements)

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“…The relatively high number of patients that were found to be culture-positive for NTMs (16%, group C) is not uncommon in the sub-Saharan African context [26]–[28]. This is probably largely due to contamination of culture samples either at patient level or from the environment as only few patients suffered from a pathogenetic relevant NTM infection that fulfilled the diagnostic criteria for a Nontuberculous Mycobacterial Lung Disease according to the American Thoracic Society [29].…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Accuracy of Computer-Aided Detection of Pulmonary Tuberculosis in Chest Radiographs: A Validation Study from Sub-Saharan Africa

et al. 2014

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BackgroundChest radiography to diagnose and screen for pulmonary tuberculosis has limitations, especially due to inter-reader variability. Automating the interpretation has the potential to overcome this drawback and to deliver objective and reproducible results. The CAD4TB software is a computer-aided detection system that has shown promising preliminary findings. Evaluation studies in different settings are needed to assess diagnostic accuracy and practicability of use.MethodsCAD4TB was evaluated on chest radiographs of patients with symptoms suggestive of pulmonary tuberculosis enrolled in two cohort studies in Tanzania. All patients were characterized by sputum smear microscopy and culture including subsequent antigen or molecular confirmation of Mycobacterium tuberculosis (M.tb) to determine the reference standard. Chest radiographs were read by the software and two human readers, one expert reader and one clinical officer. The sensitivity and specificity of CAD4TB was depicted using receiver operating characteristic (ROC) curves, the area under the curve calculated and the performance of the software compared to the results of human readers.ResultsOf 861 study participants, 194 (23%) were culture-positive for M.tb. The area under the ROC curve of CAD4TB for the detection of culture-positive pulmonary tuberculosis was 0.84 (95% CI 0.80–0.88). CAD4TB was significantly more accurate for the discrimination of smear-positive cases against non TB patients than for smear-negative cases (p-value<0.01). It differentiated better between TB cases and non TB patients among HIV-negative compared to HIV-positive individuals (p<0.01). CAD4TB significantly outperformed the clinical officer, but did not reach the accuracy of the expert reader (p = 0.02), for a tuberculosis specific reading threshold.ConclusionCAD4TB accurately distinguished between the chest radiographs of culture-positive TB cases and controls. Further studies on cost-effectiveness, operational and ethical aspects should determine its place in diagnostic and screening algorithms.

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Section: Discussionmentioning

confidence: 99%

Diagnostic Accuracy of Computer-Aided Detection of Pulmonary Tuberculosis in Chest Radiographs: A Validation Study from Sub-Saharan Africa

et al. 2014

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“…These rates are largely unknown for most countries in Africa. In South Africa, prevalence rates of NTM colonization of 1,400-6,700/100,000 persons have been reported (29,30). In gold miners in South Africa, rates of infection were 101/100,000 persons for NTM, 66/100,000 persons for M. kansasii, and 12/100,000 persons for M. scrofulaceum (31,32).…”

Section: Discussionmentioning

confidence: 99%

Nontuberculous Mycobacteria, Zambia

Buijtels¹,

Sande²,

Graaff³

et al. 2009

Emerg. Infect. Dis.

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Clinical relevance of nontuberculous mycobacteria (NTM) isolated from 180 chronically ill patients and 385 healthy controls in Zambia was evaluated to examine the contribution of these isolates to tuberculosis (TB)-like disease. The proportion of NTM-positive sputum samples was signifi cantly higher in the patient group than in controls; 11% and 6%, respectively (p<0.05). NTM-associated lung disease was diagnosed for 1 patient, and a probable diagnosis was made for 3 patients. NTM-positive patients and controls were more likely to report vomiting and diarrhea and were more frequently underweight than the NTM-negative patients and controls. Chest radiographs of NTM-positive patients showed deviations consistent with TB more frequently than those of controls. The most frequently isolated NTM was Mycobacterium avium complex. Multiple, not previously identifi ed mycobacteria (55 of 171 NTM) were isolated from both groups. NTM probably play an important role in the etiology of TB-like diseases in Zambia.

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“…Yet expected active tuberculosis for 1990 was 220/100 000 for Africa but only 31/100 000 for Europe and other Western countries 1. A probable 11 300/100 000 of the population of Transkei, South Africa, had active tuberculosis in 1977 2. The incidence of active tuberculosis is less a function of prevalence of infection with the bacillus, and more a function of host resistance.…”

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confidence: 99%

Dietary linoleic acid, immune inhibition and disease

Sammon

1999

Postgraduate Medical Journal

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SummaryReview of the evidence available in published literature supports a radical change in viewpoint with respect to disease in countries where maize is the predominant dietary component. In these countries, the pattern of disease is largely determined by a change in immune profile caused by metabolites of dietary linoleic acid. High intake of linoleic acid in a diet deficient in other polyunsaturated fatty acids and in riboflavin results in high tissue production of prostaglandin E2, which in turn causes inhibition of the proliferation and cytokine production of Th1 cells, mediators of cellular immunity. Tuberculosis, measles, hepatoma, secondary infection in HIV and kwashiorkor are all favoured by this reduction in cellular immunity. Diet-associated inhibition of the Th1 subset is a major contributor to the high prevalence of these diseases found in areas of sub-Saharan Africa where maize is the staple.

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Follow-up tuberculosis prevalence survey of Transkei

Cited by 17 publications

References 1 publication

Diagnostic Accuracy of Computer-Aided Detection of Pulmonary Tuberculosis in Chest Radiographs: A Validation Study from Sub-Saharan Africa

Diagnostic Accuracy of Computer-Aided Detection of Pulmonary Tuberculosis in Chest Radiographs: A Validation Study from Sub-Saharan Africa

Nontuberculous Mycobacteria, Zambia

Dietary linoleic acid, immune inhibition and disease

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